Language and behavioral outcomes in children with developmental disabilities using cochlear implants

Abstract

Objective: Over the past decade, the number of deaf children with developmental disabilities receiving cochlear implants has increased dramatically. However, little is known about the developmental outcomes of these children post-implantation. The current study evaluated oral language and behavioral outcomes over 3 years after implantation in a sample of typically developing deaf children and children with developmental disabilities.

Study design: A three year longitudinal study of the effects of cochlear implantation on language and behavioral outcomes in children with and without additional disabilities.

Setting: Six cochlear implant centers in the United States.

Patients: The study cohort consisted of 188 deaf children. Eighty-five percent of the sample (n = 157) had a single diagnosis of severe to profound hearing loss and 15% (n = 31) had an additional disability.

Main outcome measures: Oral language was assessed using the Reynell Developmental Language Scales, and behavioral outcomes were assessed using the Child Behavior Checklist.

Results: Results using multilevel modeling indicated that deaf children with and without additional disabilities improved significantly in oral language skills post-implantation. However, children with additional disabilities made slower progress. In terms of specific diagnoses, children with developmental disorders, such as autism, made the slowest progress over time. In addition, behavior problems increased significantly in this group, whereas behavior problems decreased over 3 years in the typically developing deaf sample.

Conclusion: Overall, given the improvements in expressive and receptive language skills documented over 3 years, these findings support the use of cochlear implants for deaf children with developmental disabilities.

Figure 1

Plots of mean receptive and expressive language raw scores over time by diagnosis.

Figure 2

Growth in receptive and expressive language on the RDLS for children with and without disabilities. These values are based on the best fit models (see Table 4), which include assessment point and group. These figures show the slower rate of increase in the AD group compared to the Deaf group.

Figure 3

Change in internalizing and externalizing behavior problems over three years post-implantation. No significant changes were found in internalizing behavior problems for both groups. The left panel figure shows that T-scores on internalizing behavior problems remain fairly stable over time for both groups. In contrast, externalizing behavior problems remained stable for the Deaf group, but increased for the AD group (see right panel figure).